Provider Demographics
NPI:1649341678
Name:DUMARAN, RAYMUND S (MD)
Entity type:Individual
Prefix:DR
First Name:RAYMUND
Middle Name:S
Last Name:DUMARAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4041 TAYLOR RD
Mailing Address - Street 2:SUITE G
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-5525
Mailing Address - Country:US
Mailing Address - Phone:757-484-5828
Mailing Address - Fax:757-484-4371
Practice Address - Street 1:4041 TAYLOR RD
Practice Address - Street 2:SUITE G
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23321-5525
Practice Address - Country:US
Practice Address - Phone:757-484-5828
Practice Address - Fax:757-484-4371
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101052406207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6063381Medicaid
VA0000000003812OtherANTHEM BCBS GROUP NUMBER
VA101433OtherCIGNA HEALTHCARE
VA22241OtherSENTARA OPTIMA OF VIRGINA
VA076715OtherANTHEM BCBS OF VA
VA200144OtherSENTARA OPTIMA VENDOR #
VA22241OtherSENTARA OPTIMA OF VIRGINA
VA0000000003812OtherANTHEM BCBS GROUP NUMBER
VA101433OtherCIGNA HEALTHCARE
541272601OtherEIN
VA22241OtherSENTARA OPTIMA OF VIRGINA
VA6063381Medicaid